Exonic splicing enhancers and exonic splicing silencers

ABSTRACT

Compounds and methods for regulation of exonic splicing enhancers and exonic splicing silencers. Compounds include polynucleotides targeted to aberrant exonic splicing enhancers and exonic splicing silencers. Compounds and methods for the diagnosis of diseases and conditions associated with aberrant exonic splicing enhancers and exonic splicing silencers. Methods for identifying splicing-sensitive disease mutations, and functional RNA elements as targets for amelioration of aberrant pre-mRNA splicing.

RELATIONSHIP TO OTHER APPLICATIONS

This application claims priority to and the benefit of U.S. provisionalapplication No. 61/512,827 filed 28 Jul. 2011, the entirety of which isfully incorporated by reference herein.

GOVERNMENT SUPPORT CLAUSE

This invention was made with Government support under grant No.R01GM085121 from the National Institutes of Health. The Government hascertain rights in this invention.

FIELD OF THE INVENTION

The invention relates to exonic splicing enhancers (ESE) and exonicsplicing silencers (ESS), ESE and ESS related to disease, methods forregulating ESE and ESS, compounds for regulating ESE and ESS, methodsfor diagnosing disease by identifying aberrant ESE and ESS, and methodsfor treating disease by regulating ESE and ESS.

BACKGROUND OF THE INVENTION

The sequences of mammalian exons perform at least two overlapping rolesin gene expression. First, exons are encoded with the primary sequencedeterminants of proteins. This information is decoded by the ribosomeand translated into functional polypeptides. Secondly, exonic sequencescontribute to pre-mRNA splicing through both sequence and localstructure. This is not surprising given the organization of mammaliangenes, which typically contain small exons (˜140 bp) flanked bythousands of base-pairs of intronic DNA sequence. The large size of manymammalian genes, and the apparent degeneracy of mammalian splice sitesmarking the 5′ and 3′ termini of introns, are also suggestive of arequirement for auxiliary cis-acting elements in facilitating exonrecognition.

Exonic sequences contain a staggering array of cis-acting elements thatdirect the activation or repression of splicing. These functionalelements are classified as either exonic splicing enhancers (ESE) orsilencers (ESS) based on their ability to stimulate or inhibit splicing,respectively. ESE and ESS elements, acting in concert with their cognatetrans-acting RNA-binding proteins, represent important components in asplicing code that specifies how, where and when mRNAs are assembledfrom their precursors. Two of the major players in establishing exonidentity are the serine and arginine-rich proteins (SR proteins) and theheterogeneous nuclear ribonucleoproteins (hnRNPs). SR proteins promotethe initial stages of spliceosome assembly by binding to ESEs andrecruiting basal splicing factors to adjacent splice sites or byantagonizing the effects of ESS elements. By contrast, hnRNPs mediatethe repressive effects of silencers and can alter recruitment of thecore splicing machinery. The interactions between silencers, enhancersand their cognate binding proteins play a critical role in the fidelityand regulation of pre-mRNA splicing.

At least 10% of all mutations identified as causing human inheriteddisease are known to alter consensus 5′ or 3′ splice sites, therebyinducing aberrant pre-mRNA splicing. Nonetheless, the roles played bypre-mRNA splicing in human genetic disease remain enigmatic. While themechanistic consequences of mutations on splice sites are fairly easy tointerpret, evaluating precisely how inherited disease-causing mutationsinfluence the loss or gain of ESE/ESS motifs is more challenging. Thisis due in part to the considerable functional overlap between proteincoding sequences and the cis-acting elements involved in splicingregulation. Hence, many missense and nonsense mutations that alter mRNAsplicing may be incorrectly assumed to impact solely upon proteinstructure-function relationships as a consequence of amino acidsubstitution or protein truncation, rather than upon splicing changesper se. It is also possible that the impact of a disease allele may bedue to the combination of an aberrant splicing event and the presence ofa normal length mutation-bearing transcript. Such multifunctional siteswithin coding regions have been identified by the intragenic mapping ofcommon single nucleotide polymorphisms (SNPs). As a consequence ofpurifying selection, SNPs appear somewhat depleted and synonymous codonbias restricted (GAA vs. GAG), revealing a silhouette of the “splicingcode” that appears position-restricted relative to the edges of exons.

SUMMARY OF THE INVENTION

The invention encompasses methods for identification ofsplicing-sensitive disease mutations, and functional RNA elements astargets for amelioration of aberrant pre-mRNA splicing. Certainembodiments of the invention include methods for reducing aberrantpre-mRNA splicing in disease-related genes by interfering with ACUAGG,CUUAGG, AUUAGG, UAGGUA, GUAGUU, or other similar regulatory hexamers.The disclosed regulatory hexamers are also useful as targets for thediagnosis of diseases and conditions.

Embodiments of the invention include compounds which interact with ESEand ESS hexamers, or which specifically bind to such hexamers, or whichcompete with cis-acting elements for binding to such hexamers. Suchcompounds of the invention may comprise polynucleotides, smallmolecules, polypeptides, polypeptide fragments, antibodies,ribonucleoproteins, protein complexes, or ribonucleoprotein complexes.Polynucleotides of the invention may be DNA or RNA, antisenseoligonucleotides, short interfering RNAs, or any of a number of nucleicacid analogs such as, for example, 2′OMe RNA, locked nucleoside analogs,phosphorodiamidate morpholino analogs, or peptide nucleic acids.

Other embodiments include methods for reducing aberrant exon splicesuppression by interfering with a regulatory hexamer such as ACUAGG,CUUAGG, AUUAGG, UAGGUA, or GUAGUU. The compounds of the invention mayinterfere with such regulatory hexamers by specific binding, or bycompeting with cis-acting elements for binding. The inventioncontemplates reduction of aberrant exon splice suppression in cellswhich may comprise disease-related genes such as, for example, OPA1,PYGM, TFR2, RPS6KA3, APC, SLC5A1, and COL4A3. In certain embodiments,the function of a regulatory sequence such as ACUAGG, CUUAGG, AUUAGG,UAGGUA, or GUAGUU can be blocked without destroying the transcript (forexample, via siRNA), allowing proper splicing of the endogenous gene tobe restored, and leading to a full or partial rescue of the phenotype.

In the present disclosure, a cis-acting regulatory element may act inconjunction with an ESS. The cis-acting element may be defined by apolymer sequence of six ribonucleotides (RNA) which act as a bindingsite for a trans-factor which through direct interaction with thecis-acting element is able to alter the splicing pattern ofpre-messenger RNA. A trans-acting factor may include all protein, RNA,or ribonucleoprotein complexes which may alter pre-mRNA splicing viadirect interaction with the corresponding pre-mRNA transcript.

The invention also encompasses methods for the diagnosis of diseases orconditions by identifying aberrant ESS hexamers in disease-associatedgenes. Examples of disease-associated genes which may be targeted by thecompounds of the invention include OPA1, PYGM, TFR2, RPS6KA3, APC,SLC5A1, and COL4A3.

An embodiment of the invention is a scoring algorithm that provides anumerical expression of the relationship between disease and neutralvariants and their differential distributions with regard to loss orgain of an ESE or ESS, as shown, for example, in FIG. 1. The score is arobust independent combination of the differential strength of thehexamer, plus the differential strength of that particular base in thehexamer.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1. Scoring schematic to express the relationship between diseaseand neutral variants and their differential distributions with respectto loss or gain of an ESE or ESS. Frequencies corresponding to HGMD andcommon SNP are shown. In the schematic, let tε{ESEloss, ESEgain,ESSloss, ESSgain}, and let S_(t,0,hgmd) . . . S_(t,n,hgmd) andS_(t,0,snp) . . . S_(t,n,snp) be normalized counts plus a pseudocountfor each hexamer in set t, such that:

Σ_(i)(S _(t,i,hgmd))=1 and Σ_(i)(S _(t,i,snp))=1.

For some hexamer k in set t, let H_(t,k,0,hgmd) . . . H_(t,k,5,hgmd) andH_(t,k,0,snp) . . . H_(t,k,5,snp) be normalized counts plus apseudocount for position 0 through 5, such that:

Σ_(i)(H _(t,k,i,hgmd))=1 and Σ_(i)(H _(t,k,i,snp))=1.

A score γ is defined for some polymorphism affecting position j ofhexamer k in set t, such that:

γ=log₂(S _(t,k,hgmd) /S _(t,k,snp))+log₂(H _(t,k,j,hgmd) /H_(t,k,j,snp)).

FIG. 2. Patterns of gain or loss of exonic splicing regulator amongpathological mutations (from HGMD) as compared to putatively neutralSNPs. In (A) and (B), bar height corresponds to the Odds Ratio (OR) ofHGMD/SNPs for the loss or gain of enhancers and silencers, respectively.Each error bar represents a two-tailed 95% confidence interval for thebar height. Directionality was expressed in the form of the ancestralstate>variant for the SNPs and healthy>disease for the HGMD mutations.(C) and (D) show Principle Component Analysis (PCA) of normalized ratiosof HGMD vs. SNP substitution for loss or gain of ESE and ESS hexamers,respectively. Each row corresponds to a single ESE or ESS hexamerwhereas each column represents loss or gain of the hexamer by a genomicvariant. Any hexamers that were not significant at the 5% level wereomitted from the heat map. Each box depicts the log ratio for the countsof HGMD/SNP causing loss or gain of a specific hexamer.

FIG. 3. Conservation of exonic splicing enhancers ablated by genomicvariants. The two-dimensional density distributions (relative values) ofESEs containing associated average PhyloP scores and distances to thenearest splice site (from 3-72 bp). The density distributions for ESEstargeted for loss by inherited disease-causing (HGMD) mutations areshown in the left panel, and by neutral SNPs are shown in the rightpanel. On the axes showing PhyloP Conservation, the light markdesignates the median PhyloP score of each density distribution and thedark mark designates a PhyloP score corresponding to a p-value of 0.05.

FIG. 4. Validation of mutations creating the enriched silencer ACUAGGusing the beta hemoglobin splicing reporter. (A) shows splicing reporterconstructs created from matched pairs of wild-type (Wt) or mutant (Mt)alleles that give rise to a gain of the ACUAGG silencer in constitutiveexons in three different disease genes: OPA1, PYGM and TFR2. GloE1,GloE2 and GloE3 designate exons 1-3 of beta hemoglobin. Thepolyadenylation signal from the bovine growth hormone 1 gene isindicated by bGH pA. Wild-type allele shown above the “v”, mutant alleleshown below the “v”, and the silencer sequence created by the mutationshown below the wild-type sequence (wild-type sequences shown of OPA1,PYGM and TFR2 are SEQ ID NO:30, SEQ ID NO:31 and SEQ ID NO:32,respectively). (B) HeLa cells were transiently transfected in triplicatewith both wild-type (Wt) and mutant (Mt) alleles. Twenty-four hoursafter transfection, cells were treated with emetine to inhibit NMD, RNAwas harvested, and the splicing efficiency determined by RT-PCR andvisualized using 6% non-denaturing (29:1) polyacrylamide gelelectrophoresis (PAGE). The graphs depict mean exon inclusion quantifiedusing an Agilent 2100 Bioanalyzer with standard error bars. Statisticalhypothesis testing on means was executed using a Welch t-test for normaldata with unequal sample size and variance using α values of 0.05 (*),0.01 (**), and 0.001 (***).

FIG. 5. Identification of trans-acting factors implicated in skipping ofthe ACUAGG-containing OPA1 allele. (A) RN-PCR analysis of OPA1 splicingreporters from HeLa cells cotransfected with non-targeting siRNA (NTi),SRSF3 siRNA (SRp20i), PTBP1 siRNA (PTBi). Lanes 1-3 and 4-6 arewild-type and mutant reporters, respectively. Statistical hypothesistesting on means was executed using a Welch t-test for normal data withunequal sample size and variance using α values of 0.05 (*), 0.01 (**),and 0.001 (***). (B) Western blot showing relative depletion of SRp20and PTB as compared to the GAPDH loading control. (C) Model for aberrantsplicing by “ACUAGG” ESS. A point mutation creating the sequence ACUAGGresults in recruitment of a silencer complex which may contain SRp20 andmembers of the hnRNP protein family, either directly or indirectly boundto the RNA sequence. The complex is involved in deterring inclusion ofthe mutant exon via mechanism(s) that still remain to be determined.

FIG. 6. Overview of the nonsense codon sequence bias in exonic splicingregulators. Bars correspond to the nonsense-coding potential of ESR lossor gain, the proportion (expressed as a percentage) of 3-mers matchingUAG, UGA, or UAA out of total 3-mers. For ESR loss, this was calculatedvia simulated mutation based on HGMD transition/transversionprobabilities. For all human internal exonic 3-mers, the nonsense-codingpotential was calculated using the same algorithm as the ESRs, exceptusing a set of all human internal exonic sequences instead of ESRhexamers. The frequencies were normalized and the values for the datagiven for ESR loss or gain were analyzed statistically (P-values from χ²goodness-of-fit test) using an α value of 0.001 (***).

BRIEF DESCRIPTION OF THE TABLES

Table 1. Summary of putative splicing-sensitive mutations, exons, andgenes associated with genetic disease.

Table 2. Summary of single nucleotide polymorphisms used in thedisclosed experiments.

Table 3. Exonic splicing enhancers significantly enriched for loss bydisease-causing mutations at 5% FDR.

Table 4. Exonic splicing enhancers significantly enriched for creationby disease-causing mutations at 5% FDR, 1% FDR or 0.1% FDR.

Table 5. Exonic splicing silencers significantly enriched for loss bydisease-causing mutations at 5% FDR.

Table 6. Exonic splicing silencers significantly enriched for creationby disease-causing mutations at 5% FDR.

Table 7. RNA-binding proteins captured by wild-type and mutant RNAligands, as identified by Multidimensional Protein IdentificationTechnology (“MudPIT”). CONTRAST output for comparisons of peptidespurified with wild-type or mutant OPA1 RNA ligands. Numbers report thepercentage of residues in the protein sequence that are represented byat least one peptide passing the filtering criteria. (A) Peptidespresent in both samples. (B) Peptides present in Mutant 200 mM (normalstringency), or both samples under loose stringency. (C) Following 200mM KCl elutions, peptides present in Healthy 200 mM (normal stringency),or both samples under loose stringency. (D) Following 200 mM KClelutions, peptides present based only on loose stringency filtering. (E)Following 200 mM KCl elutions, peptides present only in elutions fromMutant RNA baits. (F) Following 200 mM KCl elutions, peptides presentonly in elutions from Wild-type RNA baits. (G) Following 200 mM KClelutions, peptides present only in elutions from Mutant RNA baits underloose stringency. (H) Following 200 mM KCl elutions, peptides presentonly in elutions from Healthy RNA baits under loose stringency.

Table 8. RNA-binding proteins captured by wild-type and mutant RNAligands, as identified by Multidimensional Protein IdentificationTechnology (“MudPIT”). CONTRAST output for comparisons of peptidespurified with wild-type or mutant OPA1 RNA ligands following 1M KClelutions. Numbers report the percentage of residues in the proteinsequence that are represented by at least one peptide passing thefiltering criteria. (A) Peptides present in both samples. (B) Peptidespresent in either Mutant 1M, or Healthy 1M and Mutant 1M samples, underloose stringency. (C) Peptides present in either Healthy 1M, or Healthy1M and Mutant 1M samples, under loose stringency. (D) Peptides presentonly in Healthy 1M and Mutant 1M samples, under loose stringency. (E)Peptides present only in Mutant 1M samples, under normal or loosestringency. (F) Peptides present only in Healthy 1M samples, undernormal or loose stringency. (G) Peptides present only in Mutant 1Msamples, under loose stringency. (H) Peptides present only in Wild-type1M samples, under loose stringency.

Table 9. CONTRAST criteria settings used in Multidimensional ProteinIdentification Technology (“MudPIT”) for identification of RNA-bindingproteins captured by wild-type and mutant RNA ligands.

Table 10. Antisense oligonucleotides designed to target ESS hexamers andassociated disease genes.

General Representations Concerning the Disclosure

This specification incorporates by reference all documents referred toherein and all documents filed concurrently with this specification orfiled previously in connection with this application, including but notlimited to such documents which are open to public inspection with thisspecification.

DEFINITIONS

In the disclosure, the terms “a” and “an” as used herein do not denote alimitation of quantity, but rather denote the presence of at least oneof the referenced items. All publications mentioned herein areincorporated by reference for all purposes to the extent allowable bylaw.

The terms “amino acid” and “amino acid sequence” refer to anoligopeptide, peptide, polypeptide, or protein sequence, or a fragmentof any of these.

The phrase “percent identity” as applied to polynucleotide orpolypeptide sequences refers to the percentage of residue matchesbetween at least two sequences aligned using a standardized algorithmsuch as any of the BLAST suite of programs (e.g., blast, blastp, blastx,nucleotide blast and protein blast) using, for example, defaultparameters. BLAST tools are very commonly used and are available on theNCBI web site.

A “variant” of a particular polypeptide sequence is defined as apolypeptide sequence having at least 40% sequence identity to theparticular polypeptide sequence over a certain length of one of thepolypeptide sequences using blastp with the “BLAST 2 Sequences” tool setat default parameters. Such a pair of polypeptides may show, forexample, at least 50%, at least 60%, at least 70%, at least 80%, atleast 85%, at least 90%, at least 95%, or at least 98% or greatersequence identity over a certain defined length of one of thepolypeptides.

“Amplification” relates to the production of additional copies of anucleic acid sequence e.g., using polymerase chain reaction (PCR).

The term “antibody” refers to intact immunoglobulin molecules as well asto fragments thereof, such as Fab, F(ab′)2, and Fv fragments, which arecapable of binding an epitopic determinant.

The term “similarity” refers to a degree of complementarily. There maybe partial similarity or complete similarity. The word “identity” maysubstitute for the word “similarity.” A partially complementary sequencethat at least partially inhibits an identical sequence from hybridizingto a target nucleic acid is referred to as “substantially similar.”

The term “analog” as used herein encompasses variants and derivatives.

The term “antisense” refers to any composition containing a nucleic acidsequence which is complementary to the “sense” strand of a specificnucleic acid sequence. Antisense molecules may be produced by any methodincluding synthesis or transcription. Once introduced into a cell, thecomplementary nucleotides combine with natural sequences produced by thecell to form duplexes and to block either transcription or translation.The designation “negative” or “minus” can refer to the antisense strand,and the designation “positive” or “plus” can refer to the sense strand.

The terms “complementary” and “complementarity” refer to the naturalbinding of polynucleotides by base pairing. For example, the sequence“5′ A-G-T 3′” bonds to the complementary sequence “3′ T-C-A 5′.”Complementarity between two single-stranded molecules may be “partial,”such that only some of the nucleic acids bind, or it may be “complete,”such that total complementarity exists between the single strandedmolecules. The degree of complementarity between nucleic acid strandshas significant effects on the efficiency and strength of thehybridization between the nucleic acid strands.

The term “derivative” refers to the chemical modification of apolypeptide sequence, or a polynucleotide sequence. Chemicalmodifications of a polynucleotide sequence can include, for example,replacement of hydrogen by an alkyl, acyl, hydroxyl, or amino group. Aderivative polynucleotide encodes a polypeptide which retains at leastone biological or immunological function of the natural molecule. Aderivative polypeptide is one modified by glycosylation, pegylation, orany similar process that retains at least one biological orimmunological function of the polypeptide from which it was derived.

“Hybridization” refers to the process by which a polynucleotide strandanneals with a complementary strand through base pairing under definedhybridization conditions. Specific hybridization is an indication thattwo nucleic acid sequences share a high degree of identity. Specifichybridization complexes form under permissive annealing conditions andremain hybridized after the “washing” step(s). The washing step(s) isparticularly important in determining the stringency of thehybridization process, with more stringent conditions allowing lessnon-specific binding, i.e., binding between pairs of nucleic acidstrands that are not perfectly matched. Permissive conditions forannealing of nucleic acid sequences are routinely determinable by one ofordinary skill in the art and may be consistent among hybridizationexperiments, whereas wash conditions may be varied among experiments toachieve the desired stringency, and therefore hybridization specificity.Permissive annealing conditions occur, for example, at 68° C. in thepresence of about 6×SSC, about 1% (w/v) SDS, and about 100 μg/mldenatured salmon sperm DNA. Generally, stringency of hybridization isexpressed, in part, with reference to the temperature under which thewash step is carried out. Generally, such wash temperatures are selectedto be about 5° C. to 20° C. lower than the thermal melting point (T_(m))for the specific sequence at a defined ionic strength and pH. The T_(m)is the temperature (under defined ionic strength and pH) at which 50% ofthe target sequence hybridizes to a perfectly matched probe. An equationfor calculating T_(m) and conditions for nucleic acid hybridization arewell known and can be found in Sambrook et al. (1989) Molecular Cloning:A Laboratory Manual, 2^(nd) ed., vol. 1-3, Cold Spring Harbor Press,Plainview N.Y.; specifically see vol. 2, ch. 9. High stringencyconditions for hybridization between polynucleotides of the presentinvention include wash conditions of 68° C. in the presence of about0.2×SSC and about 0.1% SDS, for 1 hour. Alternatively, temperatures ofabout 65° C., 60° C., 55° C., or 42° C. may be used. SSC concentrationmay be varied from about 0.1 to 2×SSC, with SDS being present at about0.1%. Typically, blocking reagents are used to block non-specifichybridization. Such blocking reagents include, for instance, denaturedsalmon sperm DNA at about 100-200 μg/ml. Organic solvent, such asformamide at a concentration of about 35-50% v/v, may also be used underparticular circumstances, such as for RNA:DNA hybridizations. Usefulvariations on these wash conditions will be readily apparent to those ofordinary skill in the art. Hybridization, particularly under highstringency conditions, may be suggestive of evolutionary similaritybetween the nucleotides. Such similarity is strongly indicative of asimilar role for the nucleotides and their encoded polypeptides.

The term “hybridization complex” refers to a complex formed between twonucleic acid sequences by virtue of the formation of hydrogen bondsbetween complementary bases. A hybridization complex may be formed insolution (e.g., C₀t or R₀t analysis) or formed between one nucleic acidsequence present in solution and another nucleic acid sequenceimmobilized on a solid support (e.g., paper, membranes, filters, chips,pins or glass slides, or any other appropriate substrate to which cellsor their nucleic acids have been fixed).

The words “insertion” and “addition” refer to changes in an amino acidor nucleotide sequence resulting in the addition of one or more aminoacid residues or nucleotides, respectively.

The phrases “nucleic acid” and “nucleic acid sequence” refer to anucleotide, oligonucleotide, polynucleotide, or any fragment thereof.These phrases also refer to DNA or RNA of genomic or synthetic originwhich may be single-stranded or double-stranded and may represent thesense or the antisense strand, to peptide nucleic acid (PNA), or to anyDNA-like or RNA-like material.

A “variant” of a particular nucleic acid sequence is defined as anucleic acid sequence having at least 40% sequence identity to theparticular nucleic acid sequence over a certain length of one of thenucleic acid sequences using blastn with the “BLAST 2 Sequences” toolset at default parameters. Such a pair of nucleic acids may show, forexample, at least 50%, at least 60%, at least 70%, at least 80%, atleast 85%, at least 90%, at least 95% or at least 98% or greatersequence identity over a certain defined length. A variant may bedescribed as, for example, an “allelic”, “splice,” “species,” or“polymorphic” variant. A splice variant may have significant identity toa reference molecule, but will generally have a greater or lesser numberof polynucleotides due to alternate splicing of exons during mRNAprocessing. The corresponding polypeptide may possess additionalfunctional domains or lack domains that are present in the referencemolecule. Species variants are polynucleotide sequences that vary fromone species to another. The resulting polypeptides generally will havesignificant amino acid identity relative to each other. A polymorphicvariant is a variation in the polynucleotide sequence of a particulargene between individuals of a given species. Polymorphic variants alsomay encompass “single nucleotide polymorphisms” (SNPs) in which thepolynucleotide sequence varies by one nucleotide base. The presence ofSNPs may be indicative of, for example, a certain population, a diseasestate, or a propensity for a disease state.

The terms “specific binding” and “specifically binding” refer to thatinteraction between a protein or peptide and an agonist, an antibody, anantagonist, a small molecule, or any natural or synthetic bindingcomposition. The interaction is dependent upon the presence of aparticular structure of the protein or peptide, e.g., the antigenicdeterminant or epitope, recognized by the binding molecule. For example,if an antibody is specific for epitope “A,” the presence of apolypeptide containing the epitope A, or the presence of free unlabelledA, in a reaction containing free labeled A and the antibody will reducethe amount of labeled A that binds to the antibody. With respect topolynucleotides, the terms “specific binding” and “specifically binding”refer to that interaction between a polynucleotide and a complementarypolynucleotide, an agonist, an antibody, an antagonist, a smallmolecule, or any natural or synthetic binding composition. Theinteraction is dependent upon the presence of a particular structure ofthe polynucleotide recognized by the binding molecule.

DETAILED DESCRIPTION OF THE INVENTION

The embodiments disclosed herein are illustrative and exemplary and arenot meant to limit the invention. Other embodiments can be utilized andstructural changes can be made without departing from the scope of theclaims of the present invention.

The invention relates to the role of exonic splicing enhancers (ESE) andexonic splicing silencers (ESS) in disease causation, methods foridentification of splicing sensitive disease mutations, and functionalRNA elements as targets for amelioration of aberrant pre-mRNA splicing.The invention also encompasses methods for reducing aberrant pre-mRNAsplicing in disease-related genes by interfering with a regulatoryhexamer such as ACUAGG, CUUAGG, AUUAGG, UAGGUA, GUAGUU, or other similarregulatory hexamers. In alternative embodiments the method may encompassproviding a compound that competes with a cis-acting element for bindingat a hexamer site, for example, an ACUAGG site, a CUUAGG site, an AUUAGGsite, a UAGGUA site, a GUAGUU site, or other similar sites. In certainembodiments, the function of a regulatory sequence such as ACUAGG,CUUAGG, AUUAGG, UAGGUA, GUAGUU, or other similar sequences, can beblocked without destroying the transcript (for example, via siRNA),allowing proper splicing of the endogenous gene to be restored, andleading to full or partial rescue of the phenotype.

An embodiment of the invention is a method for identifying splicingsensitive disease mutations. Statistical methods were used to develop anovel stochastic model to identify genetic variation that inducesaberrant pre-mRNA splicing of disease genes. The model exploitsdifferences in distributions of non-disease associated single nucleotidepolymorphisms (SNPs) and disease-causing polymorphisms to find variationthat has a statistically significant probability of altering pre-mRNAsplicing of the affected gene.

In order to predict the splicing sensitivity of a given SNP, it would bebeneficial to consider the context with which the polymorphism occurs,including many splicing-sensitive features. Supervised learning methodscan be utilized to perform classification based upon multiple features.Although many characteristics described in previous studies are numericor nominal data values by default, expressing the numeric relationshipbetween the loss/gain of a cis-element by a SNP, and splicingsensitivity, requires a more complex approach. An embodiment of theinvention is the improvement on previous methodologies involving thecomparison of disease-causing mutations to putatively neutral SNPs. FIG.1 shows a schematic of a model that can be trained on the Human GeneMutation Database (HGMD) and common 1,000 Genomes Project SNPs foreither loss or gain of both ESEs and ESSs.

An embodiment of the invention provides for a numerical expression ofthe relationship between disease and neutral variants and theirdifferential distributions with regard to loss or gain of an ESE or ESS,for example as shown in FIG. 1. The score is a robust independentcombination of the differential strength of the hexamer, plus thedifferential strength of that particular base in the hexamer.

The advantages of this type of scoring method are multifold and overcomeat least one major caveat of a position specific scoring matrix (PSSM)approach such as those used in ESEfinder (Cartegni, et al., NucleicAcids Res. (2003) 31:3568-3571). When using PSSM to score a sequence, itis necessary to make a number of assumptions, including a possiblyinvalid assumption that each base is independent of every other base,and thus the sequence score is equal to the independent sum of the logscores at each position. In the case of RNA base stacking, for example,it is well known that adjacent bases may not be independent and mayaffect RNA stability in protein-RNA interactions. For example, for amotif that would be expressed using a single PSSM, the application ofthe model described in FIG. 1 may result in that motif being spread outover a number of different hexamers that are similar in sequence, thuspreserving the context specific mutation of a base pair given theparticular sequence around it.

An embodiment of the invention provides functional RNA elements astargets for amelioration of aberrant pre-mRNA splicing. The novelscoring model of the invention has been used to characterize thecausative mechanism of disease (cis-acting element de novo creation) forabout 1300 human inherited disease associated mutations whose causativemechanism is currently unknown or misunderstood. Human genomiccoordinates (20-30 base pairs in length) centered upon these diseaseassociated mutations represent novel therapeutic targets for antisenseoligonucleotide based chemistries or small molecule compounds. Thesetargets provide an avenue to ameliorate disease phenotypes throughrational drug design, given an understanding of the causative mechanismfor disease association of these human variants. Three such variantshave been validated and support the hypothesized mechanism of action.Variants in OPA1, TFR2, and PYGM, having HGMD IDs CM080465, CM000834,and CM991088, respectively, are supported by the data provided inSterne-Wieler et al. (Genome Res. (2001) 21:1563-1571), and disclosedbelow.

Sterne-Wieler et al. (Genome Res. (2001) 21:1563-1571) is fullyincorporated herein by reference. In addition, the Supplemental Materialfor Sterne-Wieler et al. (2001), available at:http://genome.cshlp.org/content/21/10/1563/suppl/DC1, is fullyincorporated herein by reference.

Materials and Methods

Dataset Preparations

Mutations from the Human Gene Mutation Database (HGMD, athttp://www.hgmd.org) and SNPs (30-50% heterozygosity) from the 1000Genomes Project (at http://www.1000genomes.org) were extracted andmapped to hg19 internal exons as annotated by the UCSC Known Gene track(Karolchik et al., Nucleic Acids Res. (2008) 36:D773-D779). Intersectingalleles found in both the HGMD and SNP datasets were removed from theSNP dataset. Biallelic SNPs whose ancestral allele could not bedetermined were also removed from the SNP dataset. Alleles mapping towithin the first 3 bp from a splice site were removed from the SNPdataset due to possible splice site consensus sequence overlap. HGMDmutations were divided into subsets corresponding to the nearest splicesite (5′ or 3′) and according to whether the mutation mapped toconstitutive or alternative exons. As a quality control measure, HGMDmutations mapping past half the average HGMD exon length (144 bp) from asplice site were also removed, leaving only mutations within 3 to 72 bpfrom the nearest splice site.

Odds Ratios and Binomial Estimation

ESE loss was defined as an event involving a directional change from oneallele to another that served to convert an ESE to neutral or to an ESS.ESE gain was defined as an event involving a change from either neutralor ESS to an ESE. The numbers of HGMD mutations or SNPs causing ESEloss/gain were counted. An odds ratio (OR) was calculated givenOR=[P(event|HGMD)/(1−P(event|HGMD))]/[P(event|SNP)/(1−P(event|SNP))],where the event can be loss or gain of a given ESE hexamer andP(loss|dataset)=1−P(gain|dataset). Odds ratios are plotted as bars, with95% confidence intervals (two-tailed) as error bars calculated usingstandard methods (Pagano and Gavreau (2000) Principles of Biostatistics,2nd ed., Duxbury, Calif., USA). The same assumptions and calculationswere used when considering loss or gain of ESS hexamers in neutral SNPand HGMD datasets.

In order to assess the significance of the enrichment of individual ESEhexamers in the HGMD dataset as compared to the neutral SNP dataset, thebinomial distribution was employed. For each hexamer i, the probabilityof P(HGMD[i]=k) is distributed such that HGMD[i]˜Bin(m, p[i]), whereHGMD[i] is a random variable corresponding to the number of mutationscausing loss of a particular ESE, p[i] is the neutral backgroundprobability for the particular hexamer to be targeted for loss, and n isthe total number of HGMD mutations causing loss of any ESE. The neutralbackground probability (p[i]) for each ESE hexamer i is calculated asthe number of times a neutral SNP causes loss of i plus a pseudocountnormalized over the total number of SNPs causing loss to ESEs(SNP[i]+0.5/Σ_(i) (SNP[i]+0.5)). Based on large values for n andexceptionally low values for p[i], binomial p-values are approximatedusing the Poisson distribution such that λ[i]˜np[i]. This was alsoapplied to ESE gain and both ESS loss and ESS gain, each with their ownset of neutral background probabilities. For any mutation that altersmultiple ESR hexamers, only the hexamer with the lowest binomial p-valueis used in statistical tests. The significance of each p-value isdetermined for multiple hypotheses using a Benjamini-Hochberg falsediscovery rate (FDR) of 5% (Benjamini and Hochberg, J. Roy. Statist.Soc. Ser. B (1995) 57:289-300).

Conservation of ESE Loss Hexamers

To assess the evolutionary conservation of lost ESE motifs, the averagePhyloP score was calculated from multiple orthologous alignments of 46placental mammals (Pollard et al., Genome Res. (2009) 20:110-121) foreach ESE hexamer ablated by a directional allele. Typically, PhyloPscores are used to determine the conservation of individual sequencealignment columns between species, given a null model of neutralevolution at single nucleotide resolution. These scores in the humangenome range from values as low as −13.79 to 2.94 representing the−log₁₀ (p-value) to reject the null hypothesis. The average PhyloP scorewas used to determine the relative conservation of hexamers rather thanas a strict statistical test. Using each ESE PhyloP score and itscorresponding distance to the nearest exon-intron boundary,two-dimensional Gaussian kernel density estimation was performed, andthe 3D density was plotted using R. To compare the distribution ofPhyloP scores for ESEs disrupted by HGMD mutations to that due to chancealone, 13,000 hexamers were randomly sampled from both the HGMD- andSNP-targeted exons that did not match a hexamer in the ESE dataset. Theinventors also sampled an equal size of random hexamers containing HGMDmutations which did not cause loss or gain of known ESRs. Statisticalhypothesis testing on means was executed using a Welch t-test for normaldata with unequal sample size and variance using a values of 0.05 (*),0.01 (**), and 0.001 (***). Given such large sample sizes, normalityassumptions are approximately satisfied through the asymptoticrelationship to the normal distribution provided by the central limittheorem. Additionally, we performed a non-parametric alternative, theWilcoxon Rank Sum Test, which provided similarly significant p-valuesfor each test shown.

Splicing Reporter Assay and RNAi

To assess the functional relevance of non-synonymous HGMD mutations tosplicing, DNA inserts containing the entire exon plus 50 bp of flankingintron sequence for both the matched wild-type and mutant versions ofselected mutations, flanked by NdeI and BglII restriction sites, werecreated using Custom Gene Synthesis (IDT, Coralville, Iowa). Testalleles were subcloned from the pSMART vector using NdeI and BglIIrestriction sites into the pSC14mw vector. All constructs were validatedby sequencing. Splicing reporters were transiently transfected into HeLaand 293T cells in 6-well plates using Lipofectamine 2000 (Invitrogen,Carlsbad, Calif.) following the manufacturer's instructions. Cells wereharvested 24 h post-transfection and cytoplasmic RNA was subsequentlyisolated using Tri-Reagent LS (Sigma, St. Louis, Mo.). RNA samples wereconverted to cDNA using GoScript (Promega, Madison, Wis.). 100 ng ofcDNA was used as templates for PCR using Bullseye R-Taq (MidwestScientific, St. Louis, Mo.). The sequences of the PCR primers used arethe following: Reporter Forward, caaacagacaccatggtgcacc (SEQ ID NO:26);Reporter Reverse, aacagcatcaggagtggacagatc (SEQ ID NO:27); SRSF6Forward, tacggcttcgtggagttcgag (SEQ ID NO:28); SRSF6 Reverse,tcttgccaactgcaccgactag (SEQ ID NO:29). Following PCR, the amplicons werepurified using PURELINK micro-centrifuge columns (Invitrogen). Ampliconscorresponding to alternative mRNA isoforms were separated with 6% (29:1)polyacrylamide gel electrophoresis and visualized using SYBR Safestaining (Invitrogen). Bands corresponding to exon inclusion andexclusion were cut out and validated by DNA sequencing. The linearity ofthe PCR reaction was confirmed by assaying splicing at increasing PCRcycles. Quantification was performed following 29 cycles of PCR. Ratioscorresponding to splicing efficiencies (% exon inclusion) were used toassay the effects of single nucleotide substitutions between samplesrather than the absolute amount of each product. Molar ratios of mRNAisoforms were quantified using peak integration on a DNA 1000 chip(Agilent, Santa Clara, Calif.) using an Agilent 2100 Bioanalyzer. Inorder to assay for activity of nonsense-mediated decay, we treated cellswith 100 μg/ml emetine dihydrocholoride hydrate (Fluka, St. Louis, Mo.)10 h before harvesting.

For the RNA interference assay, HeLa cells were transientlyco-transfected with both the construct and appropriate siRNA (NTi,SRp20i, or PTBi) using DharmaFECT Duo (Thermo Scientific, Waltham,Mass.) according to the manufacturer's instructions and harvested at 48h post-transfection. Nuclear protein was resolved on NOVEX 10% bis trispolyacryamide gels (Life Technologies, Carlsbad, Calif.) and transferredto Immobilon FL (Millipore, Billerica, Mass.) using a GENIE Blotter(Idea Scientific, St. Paul, Minn.). Antibodies corresponding to PTB (mAbBB7), SRp20 (Sigma), and GAPDH (Calbiochem, Billerica, Mass.) werevisualized with fluorescent labeled secondary antibodies (GE Healthcare,Pittsburgh, Pa.) using the Fluor Chem Q system (Cell Biosciences, SantaClara, Calif.). Following purification of cytoplasmic RNA usingTri-Reagent LS (Sigma), amplicons were generated using One-step RT-PCR(Invitrogen) and the following cycling program: 55° C., 30 min; 94° C.,2 min; 30 cycles of: 94° C., 30 sec; 59° C., 30 sec; 72° C., 60 sec.

RNA Affinity Chromatography

RNA affinity chromatography was performed as described in Caputi andZahler (J. Biol. Chem. (2001) 276:43850-43859), with the followingmodifications. For the OPA1 ligands, a region 35 nt upstream and 25 ntdownstream of the 5′ splice site from exon 12 of the OPA1 gene wasselected. Both the wild-type and mutant alleles were sequenced usingCustom Gene Synthesis (IDT). RNA was transcribed in vitro using T7 RNApolymerase (Ambion, Austin, Tex.), and then gel purified from 6% (19:1)polyacrylamide gels. 1500 pmol purified RNA was oxidized bymetaperiodate treatment and coupled to adipic acid dihydrazide agarosebeads (Sigma). 1.5 mg HeLa nuclear extract was incubated with the beadscoupled to wild-type or mutant RNA bait, washed and eluted withincreasing concentrations of KCl. One half of the sample was resolved by10% NOVEX NUPAGE gel electrophoresis (Life Technologies) and silverstained (Silver SNAP; BD Biosciences, San Jose, Calif.). The remaininghalf was precipitated with 20% TCA, and washed in acetone. The proteinpellet was analyzed by Multidimensional Protein IdentificationTechnology (“MudPIT”), which involves 2-dimensional chromatographyseparation followed by mass spectrometry. Differences in peptidecoverage between the wild-type and mutant eluates were quantified usingMASCOT (Perkins et al., Electrophoresis (1999) 20:3551-3567) and peptidespectra from each sample were compared using CONTRAST (Tabb et al., J.Proteome Res. (2002) 1:21-26). All peptides identified in both eluatesare listed in Tables 7 and 8. Criteria settings used for CONTRAST arelisted in Table 9.

Results

Disease-Causing Mutations Overlap with the Splicing Code

27,681 exonic disease-causing mutations (missense and nonsense, seeTable 1) were extracted from the HGMD, a proprietary, hand-curateddatabase requiring one or more pieces of causal evidence for inclusion(e.g., absence from normal controls, co-segregation of lesion andphenotype through pedigree, independent occurrence in an unrelatedpatient, etc.). For common genetic variants, 8,601 exonic singlenucleotide polymorphisms (SNPs) were extracted from the 1,000 GenomesProject (Table 2). These exonic SNPs were selected for neutrality byfiltering average heterozygosity to 30-50%, corresponding to aHardy-Weinberg minor allele frequency of at least ˜0.18. In addition,the ancestral allele (biallelic directionality) was determined bycomparison to the chimpanzee (Pan troglodytes) genome.

A set of 238 hexameric sequences corresponding to the RESCUE-ESE dataset(Fairbrother et al., Science (2002) 297:1007-1013) and 176 hexamericsequences corresponding to the FAS-hex2 ESS dataset (Wang et al., Cell(2004) 119:831-845) were employed. Each set of hexanucleotides wasexperimentally validated to enhance or silence splicing of analternative exon in a mini-gene context. The directionality of thesubstitutions, based on ancestral>variant for SNPs and wild-type>diseasefor HGMD mutations, was used to calculated odds ratios (OR), expressingthe relative likelihoods that either disease-causing mutations or theputatively neutral polymorphisms are associated with the loss or gain ofESEs or ESSs.

FIGS. 2A and 2B show the patterns of gain or loss of exonic splicingregulator among pathological mutations (from HGMD) as compared toputatively neutral SNPs. In FIG. 2A, hexamers corresponding to exonicsplicing enhancers were obtained from the RESCUE-ESE database. Eachhexamer was scored for the loss or gain (de novo creation) of an ESE bythe inherited disease-causing mutations (relative to the wild-typeallele) or putatively neutral SNPs (relative to the ancestral allele).Whereas disruption of ESEs was found to be strongly associated with themutations from the HGMD dataset by comparison with neutral SNPs, therewas substantially less evidence for the gain of ESEs in the diseasemutation dataset. In FIG. 2B, hexamers corresponding to exonic splicingsilencers were obtained from the FAS-hex2 database. In contrast to theresults shown in FIG. 2A, a strong association was noted betweendisease-causing mutations and the creation of ESS motifs in FIG. 2B.Taken together, these data suggest that exon skipping may play a keyrole in human inherited disease not only via the loss of exonic splicingenhancers but also via the gain of exonic splicing silencers.

Disease-Associated Alterations of the Splicing Code

To determine if specific cis-acting elements are more susceptible todisease-causing mutations than others relative to a background levelascertained by reference to putatively neutral SNPs, the binomialenrichment p-value for loss or gain of individual hexamer sequences wascalculated. The distribution of genomic variants across individualhexamers from the ESE and ESS datasets was visualized using PrincipleComponent Analysis for optimal leaf ordering. The log₂ ratios of HGMDmutations versus SNPs for loss or gain of individual ESE and ESShexamers with a binomial p-value significant at a 5% false discoveryrate (FDR) are depicted in FIGS. 2C and 2D. A positive log ratiocorresponds to a hexamer in a certain context that is significantlyenriched in inherited disease. Alternatively, a negative log ratiorepresents a hexamer that is polymorphic across human populations. Whiteboxes correspond to non-significant P-values given a false discoveryrate (FDR) of 5%. In FIG. 2C, hexamer clusters corresponding toESE-loss, ESE-loss and ESE-gain, and ESE-gain, are designated by regionsi, ii and iii, respectively. In FIG. 2D, hexamer clusters correspondingto ESS-gain and ESS-loss are designated by regions i and ii,respectively. The loss/gain of SRSF1-like binding sites are labeled asGAAGAA in FIG. 2C, whereas the ACUAGG hexamer is labeled as ACUAGG inFIG. 2D.

Of the 238 ESE hexamers considered in this analysis, 106 showed nosignificant difference for either loss or gain by inheriteddisease-causing mutations relative to SNPs given the 5% FDR. Similarly,67 out of 176 ESS hexamers were not significantly different between theHGMD and SNP datasets. For both ESEs and ESSs, the heat maps demonstratethat HGMD mutations are not uniformly distributed across all hexamersbut rather are enriched in select subsets corresponding to losses orgains. For ESEs, there is the observation of not only clusters ofhexamers that are both exclusively either ablated or created bydisease-causing mutations (FIG. 2C, regions i and iii), but also a smallsubset of hexamers that are subject to a significant degree of both lossand gain by disease-causing mutations (FIG. 2C, region ii). By contrastto the ESEs, a much larger number of hexamers are significantly enrichedfor disease-causing mutations that create ESSs rather than abolish ESSs(FIG. 2D, compare regions i and ii). Also examined was the loss or gainof each hexamer sequence in several different contexts, including theirproximity to the nearest 5′ or 3′ splice sites and their presence withinalternative or constitutive exons. Although the general observationsdescribed in FIGS. 2C and 2D hold true, there is inconclusive evidencefor a bias of hexamer loss or gain relative to either splice site orbetween constitutive or alternative exons.

ESEs Ablated by Disease-Causing Mutations Share Hallmarks of FunctionalSplicing Enhancers

Since evolutionary conservation usually implies functionality, it wasdetermined whether there were differences in average evolutionaryconservation between those ESE hexamers lost as a consequence ofdisease-associated mutation and those lost as a result of theintroduction of a neutral SNP allele. Because ESEs are more abundant inthe vicinity of spliced sites, and the activity of splicing enhancersdecreases with increasing distance from splice sites (Graveley andManiatis, Mol. Cell. (1998) 1:765-771; Yeo et al., Genome Biol. (2004)5:R74; Parmley et al., Mol. Biol. Evol. (2006) 23:301-309), averagePhyloP scores were evaluated across alignments of 46 placental mammalsfor HGMD- or SNP-disrupted ESE hexamers relative to their positionswithin exons.

FIG. 3 shows the bivariate density distributions of ESE hexamers lost bydisease-causing mutations and neutral SNPs (left and right panels,respectively). On the axes displaying PhyloP scores, a dark markcorresponds to the statistical threshold for evolutionary conservation(PhyloP score >1.3, α=0.05) and a light mark corresponds to the medianPhyloP scores for ESE hexamers. The median PhyloP score corresponding tothe distribution of putative ESE hexamers ablated by disease-causingmutations is 1.42 (FIG. 3, left panel, light mark), easily exceeding thestatistical threshold for evolutionary conservation. By contrast, ESEhexamers abolished by putatively neutral SNPs have much lowerdistributed average PhyloP scores, such that the median (1.02) is wellbelow the statistical threshold to reject the null hypothesis ofneutrally evolving sequence. Although the median distance of ESEs fromsplice sites is not significantly different for those disrupted by SNPsor HGMD mutations, the distribution of PhyloP scores for ESEs lost bydisease-causing mutations shifts towards higher values approachingsplice sites. By contrast, the distribution for ESEs disrupted byneutral SNPs is visibly shifted towards lower values near the edges ofexons. Overall, the density plots in FIG. 3 indicate that ESEs targetedby disease-causing mutations exhibit a bias not only towards higherconservation values, but also with respect to a location toward theedges of exons as compared to those ESEs targeted by neutral SNPs.

Disease-causing mutations often affect conserved regions of proteins. Todetermine if the conservation levels observed for ESE hexamers ablatedby disease-causing mutations could result as a byproduct of this bias,random hexamers that did not cause loss/gain of any ESR from HGMDmutation- or SNP-containing exons, as well as another subset whichencompassed HGMD mutations, were sampled. As expected, random hexamerssampled both from HGMD exons and from those containing HGMD mutationsdisplayed lower distributed evolutionary conservation values than theESEs lost by HGMD mutations (median average PhyloP scores of 1.32 and1.36 compared to 1.45, respectively; Welch test two-tailedp-value<1.79×10⁻³⁹ and 3.81×10⁻¹⁵). Furthermore, the PhyloP scores forESEs targeted by neutral SNPs were distributed lower overall than theset of random hexamers sampled from SNP-targeted exons (median averagePhyloP scores of 1.09 and 1.15, respectively; Welch test two-tailedp-value<0.039).

Functional Validation of a Splicing Silencer Mutationally Linked to 67Different Diseases Genes

In order to test the hypothesis that those exonic splicing silencersthat harbor a preponderance of disease alleles could representfunctionally repressive elements, the activity of one of the mostsignificant hexamers identified by our comparison of disease-causing andneutral polymorphisms within ESSs (designated in FIG. 2D as ACUAGG;binomial p-value<2.2×10⁻¹⁶, from Table 6) was validated. This specifichexamer appears to have been created by a total of 83 differentdisease-causing mutations in 67 different genes. This list ofdisease-causing mutations was searched for sequences that were amenablefor cloning into splicing reporter constructs, and were present in exonsof near average size and splice site strength. Of the three differentdisease-causing mutations we selected, OPA1, PYGM and TFR2, there was noa priori evidence for any effect on splicing from in vitro analysis(Schimpf et al., Hum. Mutat. (2008) 29:106-112; Bruno et al.,Neuromuscul. Disord. (1999) 9:34-37; Camaschella et al., Nat. Genet.(2000) 25:14-15). However, aberrant splicing of OPA1, PYGM and TFR2 isobserved in patients carrying coding and noncoding mutations at otherpositions in these genes (Schimpf et al., Hum. Genet. (2006)118:767-771; Nogales-Gadea et al., Hum. Mutat. (2008) 29:277-283;Biasiotto et al., Haematologica (2008) 93:309-310).

Matched pairs of beta hemoglobin-based (HBB1) splicing reporter geneconstructs containing the wild-type or mutant exon plus 50 bp ofadjacent intron sequence were created. To investigate the effects of theACUAGG silencer on splicing of the reporter genes, HeLa cells weretransiently transfected with both wild-type or mutant constructs.Because inclusion of all three of the test exons is predicted to inducenonsense-mediated decay (NMD) by inducing an in-frame prematuretermination codon (PTC), we assayed splicing in the presence of thetranslation inhibitor emetine dihydrochloride, a potent inhibitor of NMDin vivo. After RNA isolation and conversion to cDNA, each sample wastested for reporter RNA splicing efficiency. Inhibition of NMD wasconfirmed by assaying the splicing of the SRSF6 pre-mRNA, an endogenousPTC-containing gene known to undergo NMD. The presence of the SRSF6poison exon-containing mRNA shows that NMD was indeed inhibited in theemetine-positive samples. As shown in FIG. 4B, introduction of theACUAGG hexamer resulted in a remarkable degree of exon skipping in theOPA1, PYGM and TFR2 reporters. Quantification of amplicons using anAgilent 2100 Bioanalyzer demonstrated that the ACUAGG silencersignificantly decreased inclusion of the OPA1, PYGM and TFR2 test exonsfrom 97% to 44% (p-value<2.39×10⁻³), 62% to 19% (p-value<6.83×10⁻⁴) and86% to 49% (p-value<7.62×10⁻⁴), respectively (FIG. 4B). These datasuggest that it is possible to predict splicing-relevant mutations basedupon the statistical enrichment of hexamers in disease-associatedmutation datasets.

Identification of Trans-Acting Splicing Silencers

The data presented in FIG. 5 suggest that the ACUAGG motif functions asa strong splicing silencer. Splicing silencers have been shown tointeract with trans-acting factors such as hnRNPs and to alter thekinetics of the non-rate limiting steps of spliceosome assembly when two5′ splice sites are in competition (Zhu et al., Mol. Cell. (2001)8:1351-1361; Yu et al., Cell (2008) 135:1224-1236). Given thatactivation of cryptic 5′ splice sites in the mutant OPA1 construct wasnot observed, potential trans-acting factors were searched for by RNAaffinity chromatography using HeLa nuclear extracts. RNA-bindingproteins captured by the wild-type and mutant RNA ligands at low andhigh stringency were identified by Multidimensional ProteinIdentification Technology “MudPIT” (Tables 7, 8 and 9). At both high andlow concentrations of KCl, peptides corresponding to SRp20 (SRSF3), PTB(PTBP1), hnRNP D (HNRNPD) and hnRNP L (HNRNPL) were present on themutant RNA ligand (Tables 7 and 8), suggesting that these proteins mayplay a role in mediating the silencing activity of the ACUAGG hexamer.

To test the role of SRp20 and PTB in splicing silencing, HeLa cells wereco-transfected with either the wild-type or mutant OPA1 splicingreporter and siRNA targeting SRp20, PTB or a non-targeting duplex. Incells transfected with non-targeting control siRNA, the mutant OPA1reporter was inefficiently spliced relative to the wild-type reporter(FIG. 5A, compare lanes 1 and 4). By contrast, depletion of SRp20 and,to a lesser extent, PTB partially rescued inclusion of the mutant OPA1exon (FIG. 5A, compare lane 4 with lanes 5 and 6). Quantification of theRT-PCR amplicons from duplicate experiments revealed that depletion ofSRp20 and PTB restored inclusion of the mutant exon to ˜50% and ˜25% ofthe wild-type levels, respectively. Analysis of the exon inclusionratios for the SRp20 and PTB depletion revealed that only knock down ofSRp20 resulted in statistically significant changes relative to thecontrol (FIG. 5B). Depletion of both SRp20 and PTB was confirmed byfluorescent western blot analysis of nuclear extracts prepared fromtransfected cells (FIG. 5B). Quantification of the western blotsrevealed ˜2-fold and 2.75-fold depletions of SRp20 and PTB,respectively, relative to cells transfected with non-targeting controlduplex. Taken together, these data implicate SRp20 and PTB in both therecognition and function of the ACUAGG exonic splicing silencer motif.

Potential Nonsense Sequences are Enriched in ESR Hexamers

Nonsense-associated altered splicing (NAS) describes the phenomenonwhereby exons encoding premature stop codons tend to be excluded fromthe mature RNA transcript during pre-mRNA splicing in the nucleus.Although the primary mechanism of NAS is still unknown, severaldifferent models have been proposed. These include a nuclear scanningmodel that invokes the action of a frame-sensitive mechanism in pre-mRNAsplicing (Wang et al., Mol. Cell. (2002) 10:951-957). Alternatively, NASmay be the direct result of ESE disruption as a means to abolish exonrecognition (Shiga et al., J. Clin. Invest. (1997) 100:2204-2210; Liu etal., Nat. Genet. (2001) 27:55-58). In order for nonsense mutations to bespecifically associated with the loss/gain of ESR sequences, there mustbe a sequence bias in the ESRs themselves. To investigate thishypothesis for ESR loss, mutations were simulated based on thetransition/transversion rates observed for the 14,771 exonic HGMDmutations located near the edges of exons. For the ESR gains, theproportion of nonsense 3-mers (UAG, UAA, UGA) were evaluated compared toall of the 3-mers within the corresponding hexamers. As a control forthe experiment, the same algorithm was used to evaluate the “loss” or“gain” of all 3-mers (excluding the first 3 bp) in a previously used setof 206,029 human internal exons (FIG. 6; Fairbrother et al., PLoS Biol.(2004) 2:E268). Using these data, we compared the nonsense potential ofexon retention to exon skipping with respect to that of our control.

For all ESR hexamers in our datasets, we observed at least a ˜2-foldincrease in nonsense-potential consistent with silencer gains(p-value<5.50×10⁻²¹) and enhancer losses (p-value<1.27×10⁻¹⁴) whencompared to controls (χ² goodness-of-fit test, FIG. 6). As expected,minimal values of nonsense-potential were observed for silencer loss(p-value: <0.19) and enhancer gain (p-value<0.86), consistent with thenonsense-potential seen for the respective “loss” and “gain” of allhuman exonic 3-mers (χ² goodness-of-fit test, FIG. 6). The lack ofnonsense-potential for enhancer gain is not surprising given theabundance of enhancers within exons, and their being subject to proteincoding restrictions. These data therefore support a model that involvesthe disruption of enhancers and the creation of silencers to yieldnonsense-associated altered splicing (NAS). Consistent with thispostulate, it would appear as though enhancer loss and silencer gain arespecifically associated with potential-nonsense codons through thesequence bias of the ESRs.

Discussion

The results presented here demonstrate that nearly ˜25% (7,154/27,681)of exonic (i.e. missense and nonsense) mutations that cause humaninherited disease are likely to induce exon skipping either via the lossof evolutionarily conserved splicing enhancers or alternatively throughthe creation of potent splicing silencers (Table 2). Given that it hasalready been recognized that at least 10% of disease-causing mutationsablate 5′ or 3′ splice site consensus sequences (Krawczak et al., Hum.Mutat. (2007) 28:150-158), a conservative estimate is that approximatelyone third of disease-causing mutations may induce aberrant splicing. Anindependent strategy has reached a similar estimate (22%) of splicingsensitive missense/nonsense disease-causing mutations (Lim et al., Proc.Natl. Acad. Sci. USA (2011) 108:11093-11098). Future studies thatinclude mutations which affect intronic cis-elements may well increasethis proportion. Overall, the results provide new insights into theunderlying mechanisms that link mutation-induced aberrant splicing andhuman inherited disease. Understanding these mechanisms is aprerequisite for the optimization of treatment regimens as we enter theera of personalized medicine.

One surprising and unexpected result is that although genomic variantsthat create ESEs or abolish ESSs are more frequently associated withneutral SNPs (FIGS. 2A and 2B), some individual ESE and ESS hexamersshow a remarkable enrichment for disease-causing mutations when gainedor lost, respectively. This class of mutations may induce aberrantsplicing of adjacent exons, such as observed for a polymorphism in theMST1R1 gene (Ghigna et al., Mol. Cell (2005) 20:881-890). It is notablethat specific ESR hexamers, based on their HGMD/SNP log ratios, appearto be disproportionately represented by disease-causing mutations (FIG.2C, Region i and FIG. 2D, Region i). Within each of these clusters thereare individual hexamers that appear to be mutated very frequently ingenetic disease, suggesting that specific trans-acting factors may beassociated with several genetic disorders. For example, one of thesequences in the enhancer loss-enriched cluster displays a remarkabledegree of similarity to the canonical binding site for the splicingfactor SF2/ASF (SRSF1) (Tacke et al., EMBO J. (1995) 14:3540-3551;Sanford et al., Genome Res. (2009) 19:381-394) (FIG. 2C, GAAGAA).Indeed, the presence of an SF2/ASF consensus motif in this clustersupports previous evidence for the loss of ESEs as an important cause ofhuman inherited disease (Sanford et al., ibid). There are a strikingnumber of ESEs and ESSs that are relatively untouched by disease-causingmutations, but appear to be more polymorphic in different humanpopulations. These data suggest at least two non-mutually exclusivepossibilities. The first is that those hexamers that areover-represented in the SNP dataset may be redundant with the functionof other hexamers and hence more prone to variation across humanpopulations. Alternatively, the polymorphic ESRs identified here may beassociated with allele-specific alternative splicing that confers a gainof fitness rather than a disease phenotype (Fraser and Xie, Genome Res.(2009) 19:567-575).

An investigation was carried out to determine the function of a specificESS hexamer, ACUAGG (FIG. 2D), that has been created de novo by no fewerthan 83 different single nucleotide substitutions (both missense andnonsense) in 67 different genes as a cause of human inherited disease(Table 6). Reporter constructs derived from three different diseasegenes, OPA1, TFR2 and PYGM, all demonstrated that ACUAGG promotesskipping of test exons derived from the mutant alleles of each gene. Areporter construct, corresponding to an ACUAGG introduction near the 3′splice site of exon 13 from MYH7, was prepared. This mutation failed toinduce appreciable skipping of the test exon. For the case of ACUAGGinsertion in OPA1, the effects of this ectopic silencer element on exonskipping appear to be mediated, at least in part, by SRp20 and possiblyPTB. This is surprising since SR proteins are typically thought topromote exon inclusion by binding to splicing enhancers (Ram and Ast,Trends Genet. (2007) 23:5-7). It is possible that interactions betweenSRp20, PTB and other hnRNPs create an exon silencing complex thatpromotes exon skipping. A comprehensive analysis of PTB-RNA interactionsidentified many examples of alternative cassette exons that are skippedthrough the action of PTB-binding sites located near the 5′ splice site(Xue et al., Mol. Cell. (2009) 36:996-1006). The present data suggeststhat the ACUAGG hexamer is a potent splicing silencer that functions atboth 5′ and 3′ splice sites.

The impact of premature termination (nonsense) codons upon geneexpression remains an important consideration in the elucidation of thepathogenic basis of disease-causing mutations. It is well establishedthat the NMD pathway plays a central role in preventing the accumulationand translation of nonsense-containing mRNA isoforms (Maquat, Nat. Rev.Mol. Cell. Biol. (2004) 5:89-99; McGlincy and Smith, Trends Biochem.Sci. (2008) 33:385-393). However, PTCs are also suggested to directlyinfluence alternative splicing decisions (Wang et al., Mol. Cell. (2002)10:951-957; Wachtel et al., RNA (2004) 10:1740-1750). The most plausiblemodel is that PTCs disrupt ESEs and induce exon skipping (Liu et al.,Nat. Genet. (2001) 27:55-58; Cartegni et al., Nat. Rev. Genet. (2002)3:285-298; Pagani et al., J. Biol. Chem. (2003) 278:26580-26588; Zatkovaet al., Hum. Mutat. (2004) 24:491-501). The results presented in FIG. 5extend this model by suggesting that such a surveillance mechanism mightevolve via the acquisition of ESR sequences to counteract PTC-containingexons associated with a greater likelihood of skipping. The apparentbias of ESR sequences towards potential nonsense codons would appear tobe the most logical explanation for nonsense-associated altered splicing(Valentine and Heflich, RNA (1997) 3:660-676). To test this postulate,the inventors examined the very first observation of NAS where exonskipping was observed in the fibrillin (FBN1) gene due to anonsense-causing T>G transversion 26 bp from a constitutive 3′ splicesite (Dietz et al., Science (1993) 259:680-683). Consistent with themodel of the inventors, the mutation appears to create adisease-enriched silencer CUUAGG (Table 6, binomial p-value<2.2×10⁻¹⁶),with the core of the motif containing the previously observed nonsensecodon, UAG. It is suspected that many NAS observations may be consistentwith this model due to ESR sequence bias or else attributable to PCRamplification artifacts after NMD (Cartegni et al., ibid). It remains tobe determined if such a mechanism might arise as an attempt to preservethe transcript at the expense of a single exon or as a hammer to ensurethat NMD is successfully elicited by the PTC.

Regulation of ESE and ESS

The invention provides compounds and methods for reducing aberrantpre-mRNA splicing in disease-related genes by interfering with aregulatory hexamer such as ACUAGG, CUUAGG, AUUAGG, UAGGUA, GUAGUU, orother similar regulatory hexamers. In alternative embodiments the methodmay encompass providing a compound that competes with a cis-actingelement for binding at a hexamer site, for example, an ACUAGG site, aCUUAGG site, an AUUAGG site, a UAGGUA site, a GUAGUU site, or othersimilar sites. In certain embodiments, the function of a regulatorysequence such as ACUAGG, CUUAGG, AUUAGG, UAGGUA, GUAGUU, or othersimilar sequences, can be blocked without destroying the transcript (forexample, with compounds such as siRNA), allowing proper splicing of theendogenous gene to be restored, and leading to full or partial rescue ofthe phenotype.

The invention provides compounds which may comprise polynucleotides,examples of which are described in Table 10. Such polynucleotides may beDNA (deoxyribonucleic acid, with thymine bases in place of uracil bases)or RNA (ribonucleic acid, with uracil bases in place of thymine bases).In alternative embodiments, the polynucleotides of the invention areantisense oligonucleotides. In alternative embodiments, thepolynucleotides of the invention are short interfering RNAs which may,for example, function via RNA interference. In alternative embodiments,a polynucleotide of the invention may comprise one or more DNA monomers,may comprise one or more RNA monomers, may comprise one or more 2′OMeRNA (2′-O-methyl ribonucleic acid) monomers, may comprise one or morephosphorothioate-backbone connected nucleic acids, may comprise one ormore LNA (locked nucleoside analog; U.S. Pat. No. 6,794,499) monomers,may comprise one or more PMO (phosphorodiamidate morpholino) monomers,or may comprise one or more PNA (peptide nucleic acid) monomers.

In alternative embodiments, the compounds of the invention may comprisesmall molecules, proteins, polypeptides, polypeptide fragments,antibodies, protein complexes, ribonucleoproteins, or ribonucleoproteincomplexes. In alternative embodiments, such compounds may comprisepotential trans-acting factors such as SR proteins, SRp20, PTB, hnRNP Dor hnRNP L; or polypeptide fragments of SR proteins, SRp20, PTB, hnRNP Dor HNRNP L.

The invention provides methods for reducing aberrant exon splicesuppression by interfering with a regulatory hexamer such as ACUAGG,CUUAGG, AUUAGG, UAGGUA, GUAGUU, or other similar regulatory hexamers.Such methods may comprise: (1) providing a cell comprising a regulatoryhexamer, (2) providing a compound that interacts with the regulatoryhexamer, and (3) contacting the regulatory hexamer with the compound. Inalternative embodiments, such methods may be used to regulate exonicsplicing, to enhance exonic splicing, to silence exonic splicing, or tosuppress exonic splicing. In further embodiments, such methods may beused to regulate the function of ESE hexamers, or to regulate thefunction of ESS hexamers. In alternative embodiments, the compounds usedin such methods may bind specifically to the regulatory hexamer, or maycompete with a cis-acting element for binding with the regulatoryhexamer.

The invention provides methods for reducing aberrant pre-mRNA splicingby interfering with a regulatory hexamer such as ACUAGG, CUUAGG, AUUAGG,UAGGUA, GUAGUU, or other similar regulatory hexamers. Such methods maycomprise: (1) providing a cell comprising a cis-acting element, (2)providing a compound that interacts with the cis-acting element, and (3)contacting, or directly competing for contact with, the cis-actingelement with the compound. In alternative embodiments, such methods maybe used to regulate exonic splicing, to enhance exonic splicing, tosilence exonic splicing, or to suppress exonic splicing. In furtherembodiments, such methods may be used to regulate the function of ESEhexamers, or to regulate the function of ESS hexamers. In alternativeembodiments, the compounds used in such methods may bind specifically tothe regulatory hexamer, or may compete with a cis-acting element forbinding with the regulatory hexamer.

The invention provides methods to diagnose a disease or condition, or toidentify an individual having a disease or condition, or to identify acell having a genetic predisposition to a disease or condition. Suchmethods may comprise: (1) providing a cell comprising a disease-relatedgene, (2) providing a compound that binds specifically to thedisease-related gene having an aberrant regulatory ESS or ESE hexamer,and (3) detecting specific binding of the compound to the gene. Inalternative embodiments, such methods may comprise: (1) providing theRNA from a cell, (2) providing a compound that binds specifically to adisease-related gene having an aberrant regulatory ESS or ESE hexamer,and (3) detecting specific binding of the compound to the RNA.

In alternative embodiments, the diagnostic methods of the invention aredirected to the detection of the ACUAGG hexamer in the OPA1 gene. Suchmethods may be used to diagnose a disease or condition such as, forexample, optic neuropathy, optic atrophy type 1, deafness, autosomaldominant optic atrophy, autosomal dominant optic atrophy-plus syndrome,vision loss, hearing loss, progressive external ophthalmoplegia, ataxia,motor neuropathy, sensory neuropathy, or myopathy. Examples of compoundsused to detect the ACUAGG hexamer in the OPA1 gene are compoundscomprising polynucleotides comprising a sequence selected from the groupconsisting of SEQ ID NO:1, SEQ ID NO:2, SEQ ID NO:3, SEQ ID NO:4, andSEQ ID NO:5.

In alternative embodiments, the diagnostic methods of the invention aredirected to the detection of the ACUAGG hexamer in the PYGM gene. Suchmethods may be used to diagnose a disease or condition such as, forexample, glycogen storage disease, glycogen storage disease type V,exercise intolerance, rhabdomyolysis, or myoglobinuria.

In alternative embodiments, the diagnostic methods of the invention aredirected to the detection of the ACUAGG hexamer in the TFR2 gene. Suchmethods may be used to diagnose a disease or condition such as, forexample, hemochromatosis, iron overload disorder, arthritis, liverdisease, diabetes, or heart abnormalities.

In alternative embodiments, the diagnostic methods of the invention aredirected to the detection of the CUUAGG hexamer in the RPS6KA3 gene.Such methods may be used to diagnose a disease or condition such as, forexample, Coffin-Lowry syndrome, X-linked intellectual disability, shortstature, microcephaly, kyphoscoliosis, or skeletal abnormalities.Examples of compounds used to detect the CUUAGG hexamer in the RPS6KA3gene are compounds comprising polynucleotides comprising a sequenceselected from the group consisting of SEQ ID NO:6, SEQ ID NO:7, SEQ IDNO:8, SEQ ID NO:9, and SEQ ID NO:10.

In alternative embodiments, the diagnostic methods of the invention aredirected to the detection of the AUUAGG hexamer in the APC gene. Suchmethods may be used to diagnose a disease or condition such as, forexample, cancer, colon cancer, stomach cancer, familial adenomatouspolyposis, Turcot syndrome, or attenuated familial adenomatouspolyposis. Examples of compounds used to detect the AUUAGG hexamer inthe APC gene are compounds comprising polynucleotides comprising asequence selected from the group consisting of SEQ ID NO:11, SEQ IDNO:12, SEQ ID NO:13, SEQ ID NO:14, and SEQ ID NO:15.

In alternative embodiments, the diagnostic methods of the invention aredirected to the detection of the UAGGUA hexamer in the SLC5A1 gene. Suchmethods may be used to diagnose a disease or condition such as, forexample, metabolic disorders, glucose-galactose malabsorption, acidosis,glucosuria, or kidney disorders. Examples of compounds used to detectthe UAGGUA hexamer in the SLC5A1 gene are compounds comprisingpolynucleotides comprising a sequence selected from the group consistingof SEQ ID NO:16, SEQ ID NO:17, SEQ ID NO:18, SEQ ID NO:19, and SEQ IDNO:20.

In alternative embodiments, the diagnostic methods of the invention aredirected to the detection of the GUAGUU hexamer in the COL4A3 gene. Suchmethods may be used to diagnose a disease or condition such as, forexample, Alport syndrome, nephropathy, thin basement membranenephropathy, Goodpasture syndrome, kidney disorders, anti-glomerularbasement membrane nephritis, hematuria, proteinuria, end-stage renaldisease (ESRD), hearing loss, or anterior lenticonus. Examples ofcompounds used to detect the GUAGUU hexamer in the COL4A3 gene arecompounds comprising polynucleotides comprising a sequence selected fromthe group consisting of SEQ ID NO:21, SEQ ID NO:22, SEQ ID NO:23, SEQ IDNO:24, and SEQ ID NO:25.

The invention provides methods to treat a disease or condition. Suchmethods may comprising providing an effective amount of a compound to apatient, wherein the compound interacts with an aberrant ESE or ESSregulatory hexamer. In alternative embodiments, the compounds used insuch methods may bind specifically to the regulatory hexamer, or maycompete with a cis-acting element for binding with the regulatoryhexamer.

1. A compound comprising a polynucleotide, wherein the polynucleotidecomprises a sequence selected from the group consisting of SEQ IDNO:1-25.
 2. The compound of claim 1, wherein the polynucleotide consistsof a sequence selected from the group consisting of SEQ ID NO:1-25. 3.The compound of claim 1, wherein the polynucleotide is an antisenseoligomer.
 4. The compound of claim 1, wherein the polynucleotide is apolynucleotide-targeting analog or an antisense polynucleotide-targetinganalog.
 5. (canceled)
 6. The compound of claim 1, wherein thepolynucleotide is a short interfering RNA.
 7. (canceled)
 8. The compoundof claim 1, wherein the polynucleotide comprises one or morepolynucleotide monomers selected from one or more RNA monomers and oneor more DNA monomers.
 9. The compound of claim 8, wherein the one ormore polynucleotide monomers are selected from the group consisting ofone or more 2′-O-methyl ribonucleic acid monomers, one or more lockednucleoside analog monomers, one or more phosphorodiamidate morpholinomonomers and one or more peptide nucleic acid monomers.
 10. (canceled)11. (canceled)
 12. (canceled)
 13. (canceled)
 14. A method for diagnosinga disease or condition related to aberrant splicing of a disease-relatedgene, the method comprising: a) providing a cell comprising thedisease-related gene, b) providing a compound that binds specifically tothe disease-related gene having an aberrant ESS hexamer, and c)detecting specific binding of the compound to the gene.
 15. The methodof claim 14, wherein the disease-related gene is selected from the groupconsisting of OPA1, PYGM, TFR2, RPS6KA3, APC, SLC5A1, and COL4A3. 16.The method of claim 15, wherein the aberrant ESS hexamer has a sequenceselected from the group consisting of ACUAGG, CUUAGG, AUUAGG, UAGGUA,and GUAGUU.
 17. The method of claim 16, wherein the disease-related geneis OPA1 and the aberrant ESS hexamer has the sequence ACUAGG.
 18. Amethod for reducing aberrant exon splice suppression, the methodcomprising: a) providing a cell comprising an ESS hexamer having asequence selected from the group consisting of ACUAGG, CUUAGG, AUUAGG,UAGGUA, and GUAGUU; b) providing a compound that interacts with the ESShexamer; and c) contacting the ESS hexamer with the compound.
 19. Themethod of claim 18, wherein the compound binds specifically to the ESShexamer wherein the compound is selected from a group consisting of asmall molecule, a polynucleotide, an antisense oligomer, a polypeptideor a polynucleotide.
 20. (canceled)
 21. (canceled)
 22. (canceled) 23.(canceled)
 24. The method of claim 18, wherein the cell comprises adisease-related gene selected from the group consisting of OPA1, PYGM,TFR2, RPS6KA3, APC, SLC5A1, and COL4A3.
 25. A method for reducingaberrant pre-mRNA splicing, the method comprising: a) providing a cellcomprising a cis-acting element comprising a sequence selected from thegroup consisting of ACUAGG, CUUAGG, AUUAGG, UAGGUA, and GUAGUU; b)providing a compound that interacts with the cis-acting element; and c)contacting, or directly competing for contact with, the cis-actingelement with the compound.
 26. The method of claim 25, wherein thecompound binds specifically to part or the whole of the cis-actingelement.
 26. The method of claim 25, wherein the compound is s selectedfrom a group consisting of a polynucleotide, an antisense oligomer, apolypeptide or a polynucleotide a small molecule.
 27. (canceled) 28.(canceled)
 29. (canceled)
 30. The method of claim 25, wherein the cellcomprises a disease-related gene selected from the group consisting ofOPA1, PYGM, TFR2, RPS6KA3, APC, SLC5A1, and COL4A3.
 31. The method ofclaim 30, wherein the cis-acting element comprises the sequence ACUAGGand the cell comprises the disease-related gene OPA1.
 32. (canceled) 33.The method of claim 31, wherein the cis-acting element is located within50 nucleotides from an exon-intron junction.
 34. The method of claim 31,wherein the cis-acting element is located within an exon of thedisease-related gene OPA1.
 35. The method of claim 31, wherein thecis-acting element is located within an intron of the disease-relatedgene OPA1.
 36. The method of claim 31, wherein the cis-acting element iflocated within 50 nucleotides from an exon-intron junction of thedisease-related gene OPA1.
 37. The method of claim 31, wherein thecompound binds specifically to the RNA corresponding to human chromosome3, coordinate location 193361220 (Homo sapiens, build GRCh37/hg19). 38.(canceled)